George Douros from the Austin and edteaching.com recently shared another cool innovation that makes life in the ED easier. That’s right, an easy way to get plastered.
Like many EDs the Austin had to tackle the problem of messy plaster rooms, junior staff coming up with inventive but not always effective ways of applying plasters, as well as inappropriate follow up and plaster checks with prolonged (and expensive) waits. They decided they needed to take a process change approach to plastering in the ED.
This is what they came up with:
- template based plaster slabs
- an organised plaster trolley that can be moved around department
- posters illustrating by step photo-guidelines stating indications, how to and disposition
However, to really bring order to plaster chaos they reckon these are the keys:
- the use of Haftan (no financial conflicts of interest to declare) or something similar that allows the slabs to both have a snug fit and to be converted to full casts at fracture clinic. You can see what this does by looking at this video. It costs a few cents per slab.
- convincing your orthopods that it’s just as good as full casts even for manipulated fractures — here’s the evidence in their literature and a 1 year audit at the Austin showed no increased rate of slippage in Colles’ fractures.
- yearly plaster workshops for the registrars/nurse practitioners and educational videos placed on their educational website edteaching.com. At present these workshops are led by plaster techs, but in the future the supervision of ED plaster teaching for doctors and nurses will become the domain of specially trained nurse practitioners.
Also, as the templates are designed for the ‘average’ 70kg male they fit most people but not everyone. So once the slab is cut out you should try the fit out on the unbroken arm to see if any trimming needs to be done before wetting it and applying it to the injured arm. There is still an element of skill needed but much less than required for a full cast.
George has even shared his posters and templates with us for you to download if you want to give it a try in your ED (and avoid creating a plaster cast from hell):
As always, great stuff George and the Austin ED — we love your stuff!
Learn more from George Douros, the Austin and edteaching.com:
- George Douros has also created educational videos on plastering the lower limb. We’ve featured these videos on above and below knee back and U slabs in getting a leg over.